title: Sleep duration and ischemic heart disease and all-cause mortality: prospective cohort study on effects of tranquilizers/hypnotics and perceived stress.
abstract: OBJECTIVE
  This prospective study aimed to examine if sleep duration is a risk indicator for ischemic heart disease (IHD) and all-cause mortality, and how perceived stress during work and leisure time and use of tranquilizers/hypnotics modifies the association.
  
  
  METHODS
  A 30-year follow-up study was carried out in the Copenhagen Male Study comprising 5249 men (40-59 years old). Confounders included lifestyle factors (smoking, alcohol, and leisure-time physical activity), clinical and health-related factors (body mass index, blood pressure, diabetes, hypertension, and physical fitness) and social class. Men with a history of cardiovascular disease at baseline were excluded.
  
  
  RESULTS
  During follow-up, 587 men (11.9%) died from IHD and 2663 (53.9%) due to all-cause mortality. There were 276 short (<6 hours), 3837 medium (6-7 hours), and 828 long (≥8 hours) sleepers. Men who slept <6 hours had an increased risk of IHD mortality but not all-cause mortality, when referencing medium sleepers. Perceived psychological pressure during work and leisure was not a significant effect modifier for the association between sleep duration and IHD mortality. In contrast, among men using tranquilizers/hypnotics (rarely or regularly), short sleepers had a two-to-three fold increased risk of IHD mortality compared to medium sleepers. Among those never using tranquilizers/hypnotics, no association was observed between sleep duration and IHD mortality.
  
  
  CONCLUSIONS
  Short sleep duration is a risk factor for IHD mortality among middle-aged and elderly men, particularly those using tranquilizers/hypnotics on a regular or even a rare basis, but not among men not using tranquilizers/hypnotics.
authors.affiliation: National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark. ahg@nrcwe.dk.
authors.forename: Anne Helene
authors.initials: AH
authors.lastname: Garde
authors.forename: Åse Marie
authors.initials: ÅM
authors.lastname: Hansen
authors.forename: Andreas
authors.initials: A
authors.lastname: Holtermann
authors.forename: Finn
authors.initials: F
authors.lastname: Gyntelberg
authors.forename: Poul
authors.initials: P
authors.lastname: Suadicani
mesh_terms: D000328:Adult; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D017202:Myocardial Ischemia / Q000503:physiopathology*; D011446:Prospective Studies; D012890:Sleep; D013315:Stress, Psychological; D014149:Tranquilizing Agents / Q000008:administration & dosage*
chemical_list: D006993:Hypnotics and Sedatives; D014149:Tranquilizing Agents